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<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<title>Untitled Document</title>
</head>

<body style="font-family:Arial, Helvetica, sans-serif">
<form id="form1" name="form1" method="post" action="">
<table width="900" border="1" cellspacing="0" cellpadding="10">
  <tr>
    <td colspan="2" align="center"><h1>Task</h1></td>
  </tr>
  <tr>
    <td width="300">Single Staff ID: </td>
    <td width="600">
      <label for="id_staff"></label>
      <input type="text" name="id_staff" id="id_staff" />
    </td>
  </tr>
  <tr>
    <td>Responsier Notify email</td>
    <td><input type="text" name="email_responsier" id="email_responsier" /></td>
  </tr>
  <tr>
    <td>Task </td>
    <td><input type="text" name="task_title" id="task_title" style="width:500px;" /></td>
  </tr>
  <tr>
    <td>Task Link</td>
    <td><input type="text" name="task_link" id="task_link" style="width:500px;" /></td>
  </tr>
  <tr>
    <td colspan="2">Task Comment</td>
    </tr>
  <tr>
    <td colspan="2"><textarea name="task_comment" rows="5" id="task_comment" style="width:100%"></textarea></td>
  </tr>
  <tr>
    <td colspan="2" align="center"><h1>Repeat</h1></td>
  </tr>
  <tr>
    <td colspan="2" align="center">Every Working Day
      <input name="rp_1_day" type="checkbox" id="rp_1_day" value="1" /></td>
  </tr>
  <tr>
    <td colspan="2" align="center"><h3><h2>(OR)</h2> 
      Repeat Task Select Week Day </h3></td>
  </tr>
  <tr>
    <td colspan="2" align="center"><input name="rp_wk[]" type="checkbox" id="rp_wk_1" value="1" />
      Monday
      <input name="rp_wk[]" type="checkbox" id="rp_wk_2" value="2" />
      Tuesday
      <input name="rp_wk[]" type="checkbox" id="rp_wk_3" value="3" />
      Wednesday
      <input name="rp_wk[]" type="checkbox" id="rp_wk_4" value="4" />
      Thursday
      <input name="rp_wk[]" type="checkbox" id="rp_wk_5" value="5" />
      Friday
      <input name="rp_wk[]" type="checkbox" id="rp_wk_6" value="6" />
      Satday
      <input name="rp_wk[]" type="checkbox" id="rp_wk_7" value="7" />
      Sunday
      <input name="rp_wk_all" type="checkbox" id="rp_wk_all" />
      Select All
        </td>
  </tr>
  <tr>
    <td colspan="2" align="center">&nbsp;</td>
  </tr>
  <tr>
    <td colspan="2" align="center"><h3><h2>(OR)</h2>Repeat Days In Select Month</h3></td>
  </tr>
  <tr>
    <td colspan="2" align="center"><input name="rp_month[]" type="checkbox" id="rp_month_1" value="1" />
      Jan   
      <input name="rp_month[]" type="checkbox" id="rp_month_2" value="2" />
      Feb
      <input name="rp_month[]" type="checkbox" id="rp_month_3" value="3" />
      Mar
      <input name="rp_month[]" type="checkbox" id="rp_month_4" value="4" />
      Apr
      <input name="rp_month[]" type="checkbox" id="rp_month_5" value="5" />
      May
      <input name="rp_month[]" type="checkbox" id="rp_month_6" value="6" />
      Jun
      <input name="rp_month[]" type="checkbox" id="rp_month_7" value="7" />
      Jul
      <input name="rp_month[]" type="checkbox" id="rp_month_8" value="8" />
      Aug
      <input name="rp_month[]" type="checkbox" id="rp_month_9" value="9" />
      Sep
      <input name="rp_month[]" type="checkbox" id="rp_month_10" value="10" />
      Oct
      <input name="rp_month[]" type="checkbox" id="rp_month_11" value="11" />
      Nov
      <input name="rp_month[]" type="checkbox" id="rp_month_12" value="12" />
    Dec
    <input type="checkbox" name="rp_month_all" id="rp_month_all" />
    All Month
        </td>
  </tr>
  <tr>
    <td colspan="2" align="center"><label for="rp_date"></label>
      Day(s) In The Month
      <input type="text" name="rp_date" id="rp_date" />
    (1,10,28)</td>
  </tr>
  <tr>
    <td colspan="2" align="center">
      <h3><h2>(OR)</h2>Repeat In Cycle</h3></td>
  </tr>
  <tr>
    <td colspan="2" align="center"><input name="rp_cycle[]" type="checkbox" id="rp_cycle_begin" value="begin" />
      
      Date Cycle Begin 
      <input name="rp_cycle[]" type="checkbox" id="rp_cycle_end" value="end" />
      Date Cycle End 
      <input name="rp_cycle[]" type="checkbox" id="rp_cycle_middle" value="middle" />
      3rd Week Month of Each Cycle</td>
  </tr>
  <tr>
    <td colspan="2" align="center"><input type="submit" name="btn_create" id="btn_create" value="Create Task" /></td>
  </tr>
</table>
</form>
</body>
</html>
